Plastic and cosmetic surgeryKolle, Frederick Strange
Science
Plastic and cosmetic surgery
Kolle, Frederick Strange
Surgery, Plastic
The worst case of such secondary diffusion the author has ever heard
of or seen came to his attention early this year. The patient had been
subjected to a subcutaneous injection of oils for the cosmetic correction
of an abnormal deepening of the inner clavicular notch. The injected
mixture, as far as the author could learn, was made up of sweet almond,
peanut, and olive oils with two others that had been forgotten. Her
physician had made two injections several days apart with a satisfactory
result. The reaction was trifling and the parts returned to the normal in
two weeks.
Five months later the part injected became tender to the touch and began
to enlarge daily. With the increase in size a gradual inflammation
involved the whole lower region of the anterior region about the root
of the neck. Various applications were made to the part to reduce the
inflammation, but at the end of ten days a region of skin that had
indicated the pointing of an abscess burst, allowing the escape of about
eight ounces of pus. Under the most careful surgical attention this
discharge continued for about three months, until under the influence
of gauze packing the wound was made to heal from the bottom, leaving
an ugly irregular scar at the site of the opening. With the healing of
this fistular wound, however, the size of the tumor did not diminish
whatever, but continued to grow until, at the present time, one and
one half years after the injections had been made, the size of this
peculiar hyperplastic growth of ovate form measures nearly five inches
across its horizontal diameter and three and one half inches through
the vertical. It is closely adherent to the overlying thickened skin,
which has undergone a yellow pigmentary change to be considered in the
next text subdivision. The tumor is hard, painless, and freely movable
beyond the limitation of its skin attachment and rests upon the sternal
thirds of the clavicles, extending upward and forward with evidences of
traction on the whole anterior skin of the neck. Laryngoscopy discloses
nothing abnormal. The deformity is hideous, and necessitates a mode of
dress to conceal it. The patient has not as yet been operated on for the
extirpation of the growth, owing to her present physical condition, the
result of melancholia.
Scanes-Spicer injected some vaselin to correct a saddle nose with
satisfactory immediate result, but after several days the upper lids
became slightly edematous, and soon after a small hard lump, the size of
a grain of shot, was felt in the left upper lid.
Harmon Smith observed a secondary diffusion in two cases in which the
abnormality in one occurred on the side of the nose and in the other at
the inner canthus following the course of the angular vein.
While in the foregoing cases the difficulty may have been overcome by
using the cold, semisolid paraffin mixture and reducing the amount
injected, it is questionable if the diffusion could thus have been
entirely overcome.
Public-domain text, read in full here on John Shaqi.
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